How well does Euflexxa (sodium hyaluronate) work?

A [study](https://pubmed.ncbi.nlm.nih.gov/19539353/) looked at how well Euflexxa (sodium hyaluronate) worked to ease pain in people with OA by looking at their pain levels after a 50-foot walk test. About 6 months after the initial injections, people who received Euflexxa (sodium hyaluronate) experienced more significant improvement in their pain compared those who received [placebo](https://www.goodrx.com/drugs/medication-basics/pharmacy-medical-glossary). Talk with your healthcare team if you have more questions about how well Euflexxa (sodium hyaluronate) works.

How long will my pain relief last after receiving Euflexxa (sodium hyaluronate)?

How long your pain relief lasts might differ depending on your condition and how your body responds to Euflexxa (sodium hyaluronate). Research has shown that pain relief can last for [6 months](https://pubmed.ncbi.nlm.nih.gov/19539353/) if you receive three weekly injections of Euflexxa (sodium hyaluronate). Ask your prescriber about how long you might expect your pain relief to last.

How often can you get Euflexxa (sodium hyaluronate) injections?

One cycle of Euflexxa (sodium hyaluronate) treatment is made up of 3 once-weekly injections and should provide pain relief for up to 6 months. [Study shows](https://www.ferringusa.com/wp-content/uploads/sites/12/2024/04/EuflexxaPI-07-2016.pdf) you can receive another cycle Euflexxa (sodium hyaluronate) after this time, which can help ease pain for an additional 6 months. Follow up with your prescriber about how often you should receive treatment with this medication.

Euflexxa

sodium hyaluronate

Used for Osteoarthritis

Euflexxa (sodium hyaluronate) is a viscosupplement. It's a gel-like lubricant that's injected into the knee joint to ease pain from osteoarthritis (OA) in adults. It's typically prescribed for people who continue to have pain despite having tried certain treatments, such as exercise and physical therapy. Euflexxa (sodium hyaluronate) is injected by a healthcare professional once a week for 3 weeks. Some common side effects of this medication include joint pain, muscle pain, and back pain.

Reviewed by:

Kristianne Hannemann, PharmD

Allison Gourley, PharmD

Last reviewed on November 6, 2024

What is Euflexxa (sodium hyaluronate)?

What is Euflexxa (sodium hyaluronate) used for?

Pain due to osteoarthritis (OA) of the knee

How Euflexxa (sodium hyaluronate) works

Euflexxa (sodium hyaluronate) is a viscosupplement. It's similar to hyaluronic acid, a substance that's naturally found in the connective tissues in your body. When Euflexxa (sodium hyaluronate) is injected into the knee, it helps lubricate the knee joint so that you can move it smoothly. This can ease pain from osteoarthritis in the knee.

Are you looking for information on Hyalgan (sodium hyaluronate), Supartz FX (sodium hyaluronate), or Bionect (hyaluronic acid) wound dressing instead?

Drug facts

Common BrandsEuflexxa

Drug ClassViscoelastic

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

Side effects of Euflexxa (sodium hyaluronate)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Joint pain (9%)
Back pain (5%)
Diarrhea (4%)
High blood pressure (4%)
Upper respiratory tract infection (4%)

Less Common Side Effects

Headache
Cough
Nausea
Muscle and bone pain
Joint swelling

Source: Prescribing information

The following Euflexxa (sodium hyaluronate) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Blue color or flushing or redness of skin

cough

difficulty in swallowing

dizziness or feeling faint (severe)

fever

redness or pain at place of injection

skin rash, hives, and/or itching

stuffy nose

swelling of eyelids, face, or lips

tightness in chest, troubled breathing, and/or wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

headache

itching of the skin

large, nonelevated blue or purplish patches in the skin

loss of appetite

nausea and/or vomiting

stomach pain

swelling of the knee

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Euflexxa (sodium hyaluronate)

Pros

Pain relief might last longer than corticosteroids
Good option for people who've tried other treatments that didn't work well
Only need three injections
Well-tolerated, with not many side effects

Cons

Might need to wait a few weeks to experience maximum pain relief
Not a first-choice treatment for OA
Must be given by a healthcare professional
Can cause temporary pain and swelling where it's injected

Pharmacist tips for Euflexxa (sodium hyaluronate)

Mark your appointments to get your Euflexxa (sodium hyaluronate) injections on your calendar so you don't miss any doses.
Your prescriber might have you avoid physical activity after receiving Euflexxa (sodium hyaluronate). In general, take things easy for the first 48 hours right after your injection. You should avoid strenuous activities such as running, jumping, swimming, biking or standing on your feet for more than 1 hour at a time. Ask your prescriber when you can continue these physical activities again.
You can expect to experience temporary pain and swelling in the knee where Euflexxa (sodium hyaluronate) was injected. This is typically mild and should go away after 1 to 3 days. But if it doesn't, contact your prescriber.
If you're pregnant or breastfeeding, talk to your prescriber about the risks and benefits of receiving Euflexxa (sodium hyaluronate). There isn't enough information to know if it's safe for you or your baby.

Common questions about Euflexxa

No, Euflexxa isn't a steroid. It contains sodium hyaluronate, which is a gel-like substance that helps lubricate the joints and helps absorb shock from movements. There are other knee injections used to treat osteoarthritis that do contain a steroid.

No, Euflexxa isn't made from rooster combs, the red comb-like structure on top of a rooster's head. Some knee injections that contain sodium hyaluronate are made using rooster comb, which also contains the same gel-like substance that's in our knee joints. But Euflexxa is made from bacterial cells instead, and not with animal products.

Based on results in clinical studies, some people might feel less pain as soon as 1 week after the Euflexxa injection. But others might not experience a more noticeable pain relief until after the third injection in week 3. In general, people tend to see an improvement in their condition by about 2 to 3 months after a viscosupplement injection. Because everyone responds differently, it might take more or less time for you to notice a change in your pain symptoms. Talk with your healthcare team if you're not sure what to expect with Euflexxa.

A study looked at how well Euflexxa worked to ease pain in people with OA by looking at their pain levels after a 50-foot walk test. About 6 months after the initial injections, people who received Euflexxa experienced more significant improvement in their pain compared those who received placebo. Talk with your healthcare team if you have more questions about how well Euflexxa works.

How long your pain relief lasts might differ depending on your condition and how your body responds to Euflexxa. Research has shown that pain relief can last for 6 months if you receive three weekly injections of Euflexxa. Ask your prescriber about how long you might expect your pain relief to last.

One cycle of Euflexxa treatment is made up of 3 once-weekly injections and should provide pain relief for up to 6 months. Study shows you can receive another cycle Euflexxa after this time, which can help ease pain for an additional 6 months. Follow up with your prescriber about how often you should receive treatment with this medication.

Weight gain wasn't a side effect reported by people taking Euflexxa during clinical studies. If you have concerns about your weight, contact your primary care provider.

Injections like Euflexxa can cause pain and swelling at the injection site. But it's typically mild and should go away 1 to 3 days after the injection. If you're concerned about pain, ask your healthcare professional about a numbing medication before getting your injection. It's normal to experience some pain temporarily after you get your injection. But if it persists, contact your care team.

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Euflexxa (sodium hyaluronate) dosage

The average cost for 3 syringes of 2ml of 10mg/ml of Euflexxa (sodium hyaluronate) is $1,076.57 with a free GoodRx coupon. This is 23.71% off the average retail price of $1,411.07.

Syringe

Dosage	Quantity	Price as low as	Price per unit
2ml of 10mg/ml	3 syringes	$1,076.57	$358.86

Typical dosage for Euflexxa (sodium hyaluronate)

Each Euflexxa injection contains 20 mg of sodium hyaluronate.

Adults: The typical dose is one injection given into the knee joint by a healthcare professional (HCP) once a week for 3 weeks.

Interactions between Euflexxa (sodium hyaluronate) and other drugs

Euflexxa (sodium hyaluronate) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Euflexxa (sodium hyaluronate). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

How much does Euflexxa (sodium hyaluronate) cost?

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Euflexxa (brand)

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$1,076.57

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Euflexxa (sodium hyaluronate) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Euflexxa (sodium hyaluronate) will not be safe for you to take.

Current infection or skin problems in area of injection
Known allergy to hyaluronate products

What are alternatives to Euflexxa (sodium hyaluronate)?

There are a number of medications that your doctor can prescribe in place of Euflexxa (sodium hyaluronate). Compare a few possible alternatives below.

Euflexxa (sodium hyaluronate)

Used for:

Pain due to osteoarthritis (OA) of the knee

$1,076.57Lowest GoodRx priceView prices

Naproxen (Naprosyn)

Used for:

Rheumatoid arthritis (RA)
Osteoarthritis (OA)
Ankylosing spondylitis (AS) (arthritis of the spine)
Polyarticular juvenile idiopathic arthritis (arthritis in children)
Tendonitis and bursitis
Gout attacks
Pain
Menstrual cramps

$8.05Lowest GoodRx priceView prices

Triamcinolone injection (Kenalog)

Used for:

This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:

Allergies or allergic reactions
Skin conditions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia)
Nervous system conditions (e.g., multiple sclerosis)
Eye conditions
Kidney conditions
Lung conditions
Joint conditions (e.g., rheumatoid arthritis)
Lupus

$7.77Lowest GoodRx priceView prices

News about Euflexxa (sodium hyaluronate)

Injections for Knee Pain: Know Your Options

If you suffer from knee pain, either from osteoarthritis or another condition, certain injections may help. Learn about gel injections for knee pain at GoodRx.

Euflexxa (sodium hyaluronate) images

This medicine is Colorless Syringe.

References

Best studies we found

Altman, R. D., et al. (2009). A double-blind, randomized, saline-controlled study of the efficacy and safety of EUFLEXXA for treatment of painful osteoarthritis of the knee, with an open-label safety extension (the FLEXX trial). Seminars in Arthritis and Rheumatism.

Altman, R. D. (2000). Intra-articular sodium hyaluronate in osteoarthritis of the knee. Seminars in Arthritis and Rheumatism.

American College of Rheumatology. (n.d.). Osteoarthritis guideline.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

Euflexxa